Annals Consult Guys - Standardizing Venous Thromboembolism Prophylaxis in the Setting of Orthopedic Surgery
Authors: Howard H. Weitz, Geno J. Merli
Journal: Annals of Internal Medicine (2022)

Web ExclusivesSeptember 2022Annals Consult Guys - Standardizing Venous Thromboembolism Prophylaxis in the Setting of Orthopedic SurgeryFREEHoward H. Weitz, MD and Geno J. Merli, MDHoward H. Weitz, MDThomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.)Search for more papers by this author and Geno J. Merli, MDThomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W21-0010 CME/MOC SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Annals Consult Guys discuss perioperative venous thromboembolism prophylaxis with a focus on options for prophylaxis in the setting of orthopedic surgery.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment Hussam AmmarAdfinitas Health University of Maryland Capital Region Medical Center20 September 2022 VTE prophylaxis after hip and knee joint replacement I am a lifelong listener to consult guys. I am somehow confused about this presentation; the title is about the standardization of DVT prophylaxis before hip and knee replacement; however, the talk is about three different options for DVT prophylaxis. The talk cited 2012 chest guidelines but didn't mention the 2022 recommendations from the International Consensus Meeting (ICM) on VTE prophylaxis which published comprehensive guidelines that were written by 600 experts from all over the world and were published in the journal of bone and joint surgery which is the gold standard journal in orthopedics surgery (1). The guidelines recommended low-dose Aspirin as the most optimum VTE prophylaxis following TKA and THA. We didn’t hear this in the talk. I also disagree with the recommendation of not using DOAC in morbidly obese patients. This also doesn’t follow the most updated guidelines, which state that apixaban and rivaroxaban are appropriate treatments in morbidly obese patients. References 1-The ICM-VTE Hip & Knee Delegates. Recommendations from the ICM-VTE: Hip & Knee. J Bone Joint Surg Am. 2022 Mar 16;104(Suppl 1):180-231. doi: 10.2106/JBJS.21.01529. Erratum in: J Bone Joint Surg Am. 2022 Aug 3;104(15):e70. PMID: 35315610. 2-Martin KA, Beyer-Westendorf J, Davidson BL, Huisman MV, Sandset PM, Moll S. Use of direct oral anticoagulants in patients with obesity for treatment and prevention of venous thromboembolism: Updated communication from the ISTH SSC Subcommittee on Control of Anticoagulation. J Thromb Haemost. 2021 Aug;19(8):1874-1882. doi: 10.1111/jth.15358. Epub 2021 Jul 14. PMID: 34259389. Disclosures: I have no conflict of interests Author, Article, and Disclosure InformationAuthors: Howard H. Weitz, MD; Geno J. Merli, MDAffiliations: Thomas Jefferson University, Philadelphia, Pennsylvania (H.H.W., G.J.M.)Disclosures: Drs. Merli and Weitz report that they have no financial relationships or interests to disclose. All relevant financial relationships have been mitigated. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=W21-0010.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Stephanie Chang, MD, MPH, Deputy Editor, reports employment with the Agency for Healthcare Research and Quality, travel compensation from the Guidelines International Network, and participation in the Patient-Centered Outcomes Research Institute methodology committee. Vineet Chopra, MD, MSc, Deputy Editor, reports grants received from the Agency for Healthcare Research and Quality and royalties from UpToDate and Oxford University Press. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interests to disclose. Eliseo Guallar, MD, MPH, DrPH, Deputy Editor, Statistics, reports that he is employed at Johns Hopkins University. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center and consultancy with Boston Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports employment with the Perelman School of Medicine, University of Pennsylvania, and consultancies with the U.S. Food and Drug Administration and the State of Colorado. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics September 2022Volume 175, Issue 9Page: CG1 ePublished: 20 September 2022 Issue Published: September 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.Loading ...